The primary objective of the project is to determine whether a nursing intervention, intensive telephone contact, will reduce the incidence of low birth weight (LBW) deliveries in women at high risk for delivering low birth weight infants. Specific aims include the study of the effect of the intervention on specific types of LBW outcomes, the correlation of LBW with specific associated etiologic factors, the cost effectiveness of the intervention, and the effect of the intervention on state anxiety (STAI). Reducing the incidence of LBW births, which account for more than 70% of the neonatal deaths in the United States, and have also been associated with developmental delay, learning disorders and other health problems in children, is a major goal of health care in the United States. From the patient population of RHC, a clinic for low income women in Forsyth County, North Carolina, eligible women (assessed at high risk for preterm labor and/or black and/or aged 17 or less) will be randomized to a usual care or a usual care plus intervention group after consent to participate has been obtained. Women in the intervention group will receive 2-4 telephone calls per week, as agreed upon in an interview with project nurse, from 26-38 weeks gestation. State anxiety (STAI) will be assessed during the initial home visit prior to randomization, and again 4 weeks later by mail survey to determine the effect of the telephone intervention on state anxiety. Outcome data, to be collected by a data collection nurse who is blinded to study participation, will include demographic characteristics, medical and behavioral factors, maternal hospitalization(s), specific information about preterm birth, and cost data. Etiologic factors for each LBW birth will be determined through chart review by two perinatologists who are blinded to group assignment. A sample size of 1,540, 770 in each group (intervention and usual care) , will provide 80% power for a one-sided test with Type I error, alpha(1) = 0.05 that the difference in the incidence of LBW will be 33.5% less in the telephone intervention group than in the usual care group. A multiple linear logistic regression model will be used to test the primary hypothesis that the adjusted relative odds (relative risk) of LBW is less than 1.0. Prerandomization co-variables will be used for adjustment.